Lacayo, Marlene A
Lacayo, Marlene A is an sole proprietor health care provider with primary practice located at 1323 Bia Route 4 , Fort Thompson SD 57339-0200. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Lacayo, Marlene A can be contacted via phone (605) 245-1518.Contact Information
Primary practice address
1323 Bia Route 4
Fort Thompson SD 57339-0200
Phone: (605) 245-1518
Fax: (605) 245-2150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 45-710 | New York |
Profile Details
| NPI number | 1801814512 |
|---|---|
| LBN Legal business name | Lacayo, Marlene A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Nov 29th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801814512 | NPPES |
| South Dakota | MEDICAID | 5549010 |
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